CMS Publishes Brand New Reference Guide for Medicare Set-Aside Arrangements

A new Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted and is available to be downloaded on the CMS (Centers for Medicare & Medicad Services) website.This reference guide was created to consolidate  information currently found within the Workers’ Compensation Agency Services webpages and CMS Regional Office Program Memorandums, while providing WCMSA information to attorneys, Medicare beneficiaries, claimants, insurance carriers, representative payees, and

WCMSA vendors.   

CMS cautions that parties should continue to visit their website for future updates to the reference guide, including additional details regarding the Workers’ Compensation Review Contractor’s review process.

Click here to read/download the new guide.

Read more about WCMSA and workers' Compensation:

Workers' Compensation: CMS Announces New WCMSA Re ...

Feb 21, 2013

Effective immediately, if a WCMSA proposal amount was originally submitted via the web-portal, a re-evaluation of an approved WCMSA amount can be requested through the WCMSA web portal, if the claimant or submitter ...

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Toxic Lead Exposure Results in OSHA Fines for NJ Company

Exposure to lead can cause serious medical problem in both children and adults. Strict safety precautions must be observed when working with lead.

Many initial occupational exposure claims in workers' compensation resulted from the

exposure to lead in factories. Lead pigment was used in paints for many years leading to a many serious blood disorders and neurological conditions.

The U.S. Department of Labor's Occupational Safety and Health Administration has cited Henry RAC Holding Corp. with four repeat and four serious safety and health violations, including workers exposed to lead hazards, at the company's Bayonne facility. The inspection was initiated in September 2012 after health hazards were discovered during an earlier OSHA safety inspection at the facility. Proposed penalties total $72,000.

Official Disabilities Guidelines Now Covers Diabetes

Today's post comes from guest author Paul J. McAndrew, Jr. from Paul McAndrew Law Firm.

While diabetes is not a work injury or illness, it can have a serious impact on the rate at which an injured worker recovers. For instance, people with diabetes may have a much harder time healing from a foot or leg injury.

The latest edition of the annual Official Disabilities Guidelines (ODG) has been released, including the latest ODG volume on treating patients. ODG Treatment is the nationally recognized standard for medicine in determining the scope and duration of medical treatment in workers’ compensation.

Should Employers Hire Smokers?

Workers' Compensation claims seem to increase with both complexity and severity when a worker is a smoker and suffers an occupational exposure. The class case is the synergistic effect that smoking has with some carcinogenic substance such as asbestos.

The ethical implications are reviewed this week in the New England Journal of Medicine

 where the authors seem to take the position that smokers should not be punished, but rather reformed.

"Finding employment is becoming increasingly difficult for smokers. Twenty-nine U.S. states have passed legislation prohibiting employers from refusing to hire job candidates because they smoke, but 21 states have no such restrictions. Many health care organizations, such as the Cleveland Clinic and Baylor Health Care System, and some large non–health care employers, including Scotts Miracle-Gro, Union Pacific Railroad, and Alaska Airlines, now have a policy of not hiring smokers — a practice opposed by 65% of Americans, according to a 2012 poll by Harris International. We agree with those polled, believing that categorically refusing to hire smokers is unethical: it results in a failure to care for people, places an additional burden on already-disadvantaged populations, and preempts interventions that more effectively promote smoking cessation."

Ciba, Toms RIver NJ and a Cancer Epidemic

Early in my workers' compensation career, during the 1980's, I was asked by a local attorney to participate in the prosecution of 3 brain cancer workers' compensation claims. The cases arose out of an alleged exposure to toxic substances while working at the Ciba-Geigy's chemical plant in Toms River, NJ. 

Being a notoriously zealous attorney, I undertook the claims. They were being defended personally by named partner in a mega-NJ liability firm. After several hearing dates, and my motion being granted for an on-site inspection of the premises with Judge being present, the claims were ended to the satisfaction of my clients.

The story of Ciba-Geigy and the plight of the employees and the community is now the subject of an insightful book, Toms River, A story of Science and Salvation authored by Dan Fagin.

Click here to hear the NPR Story - For Toms River, An Imperfect Salvation

The Going and Coming Rule: Parking Lot Injury Held Not Compensable

A NJ appellate court ruled that an employee who was severely injured in a parking lot as a result of a slip and fall was not entitled to workers’ compensation benefits since the injury occurred “off the premises” and the employer did not control the employee’s parking.

The Court also ruled, that even though a separate corporation that owned the parking lot, the corporate veil could not be pierced in absence of the proof of fraud by the employer. The employer merely rented the store premises and not the parking lot. 

Cottone v Medical Supply Corp. and NJ Manufacturers (Intervener) 
2013 WL 1136114 (N.J.Super.A.D.) Decided March 20, 2013

California: Million Dollar Verdict Reinstated in Asbestos Case

Court rules granting a Motion Not Withstanding the Verdict was premature in mesothelioma / asbestos exposure case.

"The trial court erred, both procedurally and substantively, by granting judgment notwithstanding the jury’s verdict.  The judgment must be reversed, automatically reinstating the original judgment entered on the jury’s verdict.  

"Because the judgment must be reinstated in the Webbs’ favor, we do not consider their appeal from the jury’s verdict denying their consumer-expectation products-liability claim, which they made expressly contingent on this court’s failure to “otherwise reverse and order judgment” on the failure-to-warn or general negligence claims.

Webb v Special Electric Company Inc. 
www.courts.ca.gov/opinions/documents/B233189.DOC

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